Soolantra alternatives: What can I take instead of Soolantra?

Compare Soolantra alternatives | MetroGel | Finacea | Oracea | Mirvaso | Rhofade | Natural alternatives | How to switch meds

Soolantra is a prescription-only topical cream indicated for use in inflammatory lesions of  rosacea. Rosacea is a chronic inflammatory disease and is often referred to as adult acne. It is characterized by flushing, erythema, telangiectasia, papules, and pustules on the face.  There are four recognized subtypes of rosacea, and a patient can suffer from more than one type simultaneously.  The four subtypes are erythematotelangiectatic, papulopustular, phymatous, and ocular. It is not always known why a patient suffers from rosacea, though we believe genetics, environmental factors, and microorganisms on the skin are some of the more common reasons. It is more common in women than men, and it typically occurs between the ages of 30 and 50. Diagnosis is mostly a visual judgment by a dermatologist or other healthcare provider, and many mild cases may go undiagnosed.

One of the most bothersome aspects of rosacea is the symptom of erythema which is a superficial reddening of the skin caused by a dilation of the capillaries (small surface blood vessels) on the central areas of the face. Erythema is typically patchy in appearance and occurs across the nose and cheeks. It is one of the first clinical presentations of rosacea. 

Another common symptomatic presentation of rosacea is inflammatory lesions known as papules and pustules. You might just refer to these as “pimples.” Soolantra was approved in 1996 to treat inflammatory lesions associated with papulopustular rosacea. The active ingredient in Soolantra cream is an antiparasitic known as ivermectin. While ivermectin products are available in various oral and topical dosage forms, Soolantra is a 1% concentration of ivermectin cream specifically for rosacea. Ivermectin is an antiparasitic drug that has been the subject of much controversy surrounding its off-label use in COVID-19 patients. The Food and Drug Administration (FDA) has issued a consumer update about ivermectin use in COVID-19, and you can find that information here. While we understand the mechanism of the oral medication in the treatment of parasites, we do not know exactly how ivermectin in topical form works to treat bumps, redness, and blemishes associated with rosacea. However, despite not knowing the exact mechanism of action or how it works, it has been shown to be highly effective.

The treatment of rosacea must be tailored to the individual. Some symptoms of rosacea are more prominent or bothersome for some people versus others. Soolantra may not be the best option for everyone. The first hurdle for some may be price. Soolantra has recently become available generically, but the out-of-pocket price for generic Soolantra can still be very expensive. A Singlecare savings card can lower the price of Soolantra to about $550, but for many, that may still be a tough price to pay. The manufacturer of brand-name Soolantra, Galderma, still offers a savings card that is applicable to some who prefer the brand name product. Though systemic absorption is thought to be minimal when ivermectin is used topically, ivermectin products should not be used in pregnant or breastfeeding patients.

While Soolantra is specifically aimed to reduce the inflammatory lesions associated with rosacea, patients may experience other rosacea symptoms like erythema, for which Soolantra may not provide adequate resolution. You may need an additional or alternative product to treat all symptoms adequately. While the incidence of side effects from Soolantra is relatively low, it can cause a skin burning sensation for some, which may be a barrier to continued therapy. Other adverse effects include dry skin or an allergic reaction. What should you do if you experience adverse events or feel Soolantra isn’t the best option for you? Speak to your prescriber about alternatives. Below, we will provide you with some alternative treatment options to discuss. This is not to be considered medical advice, but simply suggestions for alternatives you can speak to your dermatology specialist about.

What can I take in place of Soolantra?

Treatment options are best when tailored to the specific symptoms(s) that are most bothersome. Extreme redness in the face can be eased with drugs that constrict blood vessels on the surface such as brimonidine or oxymetazoline. Pimples and papules are typically best treated by antibiotic or anti-infective therapy, and that may be either oral or topical. Oral blood pressure medications also help control redness by controlling the dilation of surface capillaries. In some more extreme cases, laser and surgical treatment may be an option. Below you will find information on some of the most common alternatives to Soolantra. Most rosacea treatment options are prescription drugs, though some may be obtained over-the-counter.

Other alternatives to Soolantra

• Azelex (azelaic acid)
• Monodox (doxycycline)
• MetroLotion (metronidazole)
• Vibramycin (doxycycline)
• Rosadan (metronidazole)
• Bencort (benzoyl peroxide/ hydrocortisone)
• Avar-E (sulfacetamide sodium/ sulfur)
• SSS 10-5 (sulfacetamide sodium/ sulfur)
• Doryx (doxycycline)

Top 5 Soolantra alternatives

The following are some of the most common alternatives to Soolantra.

1. MetroGel (metronidazole)

MetroGel, a topical gel product containing the anti-infective metronidazole, is a viable alternative to Soolantra. This drug is also indicated in the treatment of inflammatory lesions of rosacea. Metrogel is available in 0.75% and 1% strengths. Metrogel has been available generically for some time and is typically more cost-effective than Soolantra. One tube of MetroGel can be obtained for less than $50 with a prescription savings card from SingleCare as compared to $550 for the Soolantra generic.

2. Finacea (azelaic acid)

Finacea is an azelaic acid formulation available in topical gel or foam preparation. It is effective at reducing pustules and papules associated with rosacea. It may also have some effect on the erythema associated with rosacea, though it may not work for erythema in all patients. Finacea is also a cost-effective option since its generic can be obtained for about $40 from many pharmacies with a savings card from SingleCare.

3. Oracea (doxycycline)

Oracea is an oral doxycycline formulation specifically for rosacea treatment available by prescription only. Oracea is an oral capsule containing pellets designed for a special sustained release. The dose is one 40 mg capsule once every morning. Oracea is specially formulated for rosacea and is indicated to treat rosacea only. Other doxycycline products may be used in the treatment of rosacea as well, though they may not offer the low dose and once daily dose advantages of Oracea. Oracea does have a generic equivalent on the market which may be more cost-effective than Soolantra or other options.

4. Mirvaso (brimonidine)

Mirvaso is a 0.33% brimonidine gel indicated in the treatment of erythema associated with rosacea. Brimonidine works by causing vasoconstriction in smooth muscles which diverts blood flow away from the face. Mirvaso is a good treatment option for a primary complaint of erythema and can be used with other products which may treat other bothersome symptoms of rosacea.

5. Rhofade (oxymetazoline)

Rhofade is a 1% oxymetazoline cream also indicated specifically for the erythema associated with rosacea. It works similarly to Miravaso in that it causes vasoconstriction and therefore reduces facial redness by limiting blood flow to the surface of the face.

Natural alternatives to Soolantra

There are herbal and natural therapeutic options that have been used to relieve rosacea symptoms. Compounds containing licorice, green tea, oatmeal, lavender, and chamomile are among some of the more common herbal supplements used for rosacea due to their anti-inflammatory effects. The challenge is that some ingredients in certain compounds which contain these active ingredients could make rosacea worse. Apple cider vinegar also has anti-inflammatory properties, but when used undiluted on the skin, it can actually make rosacea worse. Make sure you discuss your herbal use with your doctor or pharmacist first. 

Dry eye related to rosacea has been shown to be relieved by omega-3 fatty acid supplementation. Another common supplement, vitamin D, is thought to play a role in rosacea symptoms. Vitamin D has long been known for its regulatory immune functions, but clinical trials have shown that patients with higher vitamin D serum levels are more likely to suffer from rosacea.

There are some lifestyle changes you can make to help prevent rosacea from occurring or getting worse. Protecting your skin from the sun, wind, and extreme cold will limit skin irritation from element exposure. Avoid overheating, during exercise, for example, and this worsens flushing and erythema. Choose to drink cold beverages over warm ones, and avoid alcohol as it increases flushing as well. Your overall skin condition is a factor in rosacea, and it is important to practice good skin care and hygiene habits to minimize your rosacea symptoms.  There is no one natural cure for rosacea, but these lifestyle modifications may provide significant relief.

How to switch to a Soolantra alternative

If you feel Soolantra isn’t the right choice for your rosacea treatment or isn’t adequately controlling all symptoms of your rosacea, speak to your prescriber. There are several alternatives to Soolantra in the treatment of rosacea. Whether you prefer an oral dosage form or topical treatments, there are several options to treat rosacea. Another consideration is the timing of dosing and application. When speaking to your prescriber, factor in your lifestyle and whether once or twice daily dosing is something you can be compliant with.

If cost is your primary concern, visit the manufacturer’s website to learn more about their copay savings card. SingleCare offers prescription savings of up to 80% on many prescriptions and is easy to access from your phone.